| Center For Life Management Llc | |
|
15804 Big Cypress Dr Edmond OK 73013-1755 | |
| (405) 821-8182 | |
| Not Available |
| Full Name | Center For Life Management Llc |
|---|---|
| Speciality | Counselor |
| Location | 15804 Big Cypress Dr, Edmond, Oklahoma |
| Authorized Official Name and Position | Calvin L Smith (PRESIDENT) |
| Authorized Official Contact | 4058218182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Life Management Llc 15804 Big Cypress Dr Edmond OK 73013-1755 Ph: (405) 821-8182 | Center For Life Management Llc 15804 Big Cypress Dr Edmond OK 73013-1755 Ph: (405) 821-8182 |
| NPI Number | 1689032914 |
|---|---|
| Provider Enumeration Date | 02/01/2016 |
| Last Update Date | 10/04/2024 |
| Certification Date | 10/04/2024 |
| Medicare PECOS PAC ID | 5991237232 |
|---|---|
| Medicare Enrollment ID | O20241011002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689032914 | NPI | - | NPPES |
| Provider Name | Calvin L Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043464217 PECOS PAC ID: 6103358445 Enrollment ID: I20241011001990 |
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